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Prediction of coronary heart disease using risk factor categories
The objective of this study was to examine the association of Joint National Committee (JNC-V) blood pressure and National Cholesterol Education Program (NCEP) cholesterol categories with coronary heart disease (CHD) risk, to incorporate them into coronary prediction algorithms, and to compare the d...
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| Published in: | Circulation (New York, N.Y.) N.Y.), 1998-05, Vol.97 (18), p.1837-1847 |
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| Main Authors: | , , , , , |
| Format: | Article |
| Language: | English |
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| cited_by | cdi_FETCH-LOGICAL-c576t-60332e528fe4de449452fae31797227b3b45349a412eb26fe6351ba9993e02383 |
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| cites | cdi_FETCH-LOGICAL-c576t-60332e528fe4de449452fae31797227b3b45349a412eb26fe6351ba9993e02383 |
| container_end_page | 1847 |
| container_issue | 18 |
| container_start_page | 1837 |
| container_title | Circulation (New York, N.Y.) |
| container_volume | 97 |
| creator | WILSON, P. W. F D'AGOSTINO, R. B LEVY, D BELANGER, A. M SILBERSHATZ, H KANNEL, W. B |
| description | The objective of this study was to examine the association of Joint National Committee (JNC-V) blood pressure and National Cholesterol Education Program (NCEP) cholesterol categories with coronary heart disease (CHD) risk, to incorporate them into coronary prediction algorithms, and to compare the discrimination properties of this approach with other noncategorical prediction functions.
This work was designed as a prospective, single-center study in the setting of a community-based cohort. The patients were 2489 men and 2856 women 30 to 74 years old at baseline with 12 years of follow-up. During the 12 years of follow-up, a total of 383 men and 227 women developed CHD, which was significantly associated with categories of blood pressure, total cholesterol, LDL cholesterol, and HDL cholesterol (all P or =130/85). The corresponding multivariable-adjusted attributable risk percent associated with elevated total cholesterol (> or =200 mg/dL) was 27% in men and 34% in women.
Recommended guidelines of blood pressure, total cholesterol, and LDL cholesterol effectively predict CHD risk in a middle-aged white population sample. A simple coronary disease prediction algorithm was developed using categorical variables, which allows physicians to predict multivariate CHD risk in patients without overt CHD. |
| doi_str_mv | 10.1161/01.cir.97.18.1837 |
| format | article |
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This work was designed as a prospective, single-center study in the setting of a community-based cohort. The patients were 2489 men and 2856 women 30 to 74 years old at baseline with 12 years of follow-up. During the 12 years of follow-up, a total of 383 men and 227 women developed CHD, which was significantly associated with categories of blood pressure, total cholesterol, LDL cholesterol, and HDL cholesterol (all P<.001). Sex-specific prediction equations were formulated to predict CHD risk according to age, diabetes, smoking, JNC-V blood pressure categories, and NCEP total cholesterol and LDL cholesterol categories. The accuracy of this categorical approach was found to be comparable to CHD prediction when the continuous variables themselves were used. After adjustment for other factors, approximately 28% of CHD events in men and 29% in women were attributable to blood pressure levels that exceeded high normal (> or =130/85). The corresponding multivariable-adjusted attributable risk percent associated with elevated total cholesterol (> or =200 mg/dL) was 27% in men and 34% in women.
Recommended guidelines of blood pressure, total cholesterol, and LDL cholesterol effectively predict CHD risk in a middle-aged white population sample. A simple coronary disease prediction algorithm was developed using categorical variables, which allows physicians to predict multivariate CHD risk in patients without overt CHD.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/01.cir.97.18.1837</identifier><identifier>PMID: 9603539</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; Aged ; Algorithms ; Biological and medical sciences ; Blood Pressure ; Body Mass Index ; Cardiology. Vascular system ; Cholesterol - blood ; Cholesterol, LDL - classification ; Cohort Studies ; Comorbidity ; Coronary Disease - epidemiology ; Coronary heart disease ; Diabetes Mellitus - epidemiology ; Female ; Follow-Up Studies ; Heart ; Humans ; Lipids - blood ; Male ; Medical sciences ; Middle Aged ; National Health Programs ; Proportional Hazards Models ; Risk Factors ; Smoking - epidemiology</subject><ispartof>Circulation (New York, N.Y.), 1998-05, Vol.97 (18), p.1837-1847</ispartof><rights>1998 INIST-CNRS</rights><rights>Copyright American Heart Association, Inc. May 12, 1998</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c576t-60332e528fe4de449452fae31797227b3b45349a412eb26fe6351ba9993e02383</citedby><cites>FETCH-LOGICAL-c576t-60332e528fe4de449452fae31797227b3b45349a412eb26fe6351ba9993e02383</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2228803$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9603539$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>WILSON, P. W. F</creatorcontrib><creatorcontrib>D'AGOSTINO, R. B</creatorcontrib><creatorcontrib>LEVY, D</creatorcontrib><creatorcontrib>BELANGER, A. M</creatorcontrib><creatorcontrib>SILBERSHATZ, H</creatorcontrib><creatorcontrib>KANNEL, W. B</creatorcontrib><title>Prediction of coronary heart disease using risk factor categories</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>The objective of this study was to examine the association of Joint National Committee (JNC-V) blood pressure and National Cholesterol Education Program (NCEP) cholesterol categories with coronary heart disease (CHD) risk, to incorporate them into coronary prediction algorithms, and to compare the discrimination properties of this approach with other noncategorical prediction functions.
This work was designed as a prospective, single-center study in the setting of a community-based cohort. The patients were 2489 men and 2856 women 30 to 74 years old at baseline with 12 years of follow-up. During the 12 years of follow-up, a total of 383 men and 227 women developed CHD, which was significantly associated with categories of blood pressure, total cholesterol, LDL cholesterol, and HDL cholesterol (all P<.001). Sex-specific prediction equations were formulated to predict CHD risk according to age, diabetes, smoking, JNC-V blood pressure categories, and NCEP total cholesterol and LDL cholesterol categories. The accuracy of this categorical approach was found to be comparable to CHD prediction when the continuous variables themselves were used. After adjustment for other factors, approximately 28% of CHD events in men and 29% in women were attributable to blood pressure levels that exceeded high normal (> or =130/85). The corresponding multivariable-adjusted attributable risk percent associated with elevated total cholesterol (> or =200 mg/dL) was 27% in men and 34% in women.
Recommended guidelines of blood pressure, total cholesterol, and LDL cholesterol effectively predict CHD risk in a middle-aged white population sample. A simple coronary disease prediction algorithm was developed using categorical variables, which allows physicians to predict multivariate CHD risk in patients without overt CHD.</description><subject>Adult</subject><subject>Aged</subject><subject>Algorithms</subject><subject>Biological and medical sciences</subject><subject>Blood Pressure</subject><subject>Body Mass Index</subject><subject>Cardiology. Vascular system</subject><subject>Cholesterol - blood</subject><subject>Cholesterol, LDL - classification</subject><subject>Cohort Studies</subject><subject>Comorbidity</subject><subject>Coronary Disease - epidemiology</subject><subject>Coronary heart disease</subject><subject>Diabetes Mellitus - epidemiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart</subject><subject>Humans</subject><subject>Lipids - blood</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>National Health Programs</subject><subject>Proportional Hazards Models</subject><subject>Risk Factors</subject><subject>Smoking - epidemiology</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><recordid>eNpdkFtLwzAUgIMoc05_gA9CEfGtNZe2aR7H8DIYKKLPIU1PZmbXzKR98N-bsbIH4UA4nO9c8iF0TXBGSEkeMMm09ZngGaliMH6CpqSgeZoXTJyiKcZYpJxReo4uQtjEtGS8mKCJKDGLyBTN3zw0VvfWdYkziXbedcr_Jl-gfJ80NoAKkAzBduvE2_CdGKV75xOtelg7byFcojOj2gBX4ztDn0-PH4uXdPX6vFzMV6kueNmncSGjUNDKQN5Anou8oEYBI1xwSnnN6nhzLlROKNS0NFCygtRKCMEAU1axGbo_zN159zNA6OXWBg1tqzpwQ5BcVBXHEZ-h23_gxg2-i7dJSujeBqURIgdIexeCByN33m7jzyXBcu9WYiIXy3cpuCSV3LuNPTfj4KHeQnPsGGXG-t1YV0Gr1njVaRuOWFxbVdHCHxfuf7w</recordid><startdate>19980512</startdate><enddate>19980512</enddate><creator>WILSON, P. W. F</creator><creator>D'AGOSTINO, R. B</creator><creator>LEVY, D</creator><creator>BELANGER, A. M</creator><creator>SILBERSHATZ, H</creator><creator>KANNEL, W. B</creator><general>Lippincott Williams & Wilkins</general><general>American Heart Association, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>19980512</creationdate><title>Prediction of coronary heart disease using risk factor categories</title><author>WILSON, P. W. F ; D'AGOSTINO, R. B ; LEVY, D ; BELANGER, A. M ; SILBERSHATZ, H ; KANNEL, W. B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c576t-60332e528fe4de449452fae31797227b3b45349a412eb26fe6351ba9993e02383</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Algorithms</topic><topic>Biological and medical sciences</topic><topic>Blood Pressure</topic><topic>Body Mass Index</topic><topic>Cardiology. Vascular system</topic><topic>Cholesterol - blood</topic><topic>Cholesterol, LDL - classification</topic><topic>Cohort Studies</topic><topic>Comorbidity</topic><topic>Coronary Disease - epidemiology</topic><topic>Coronary heart disease</topic><topic>Diabetes Mellitus - epidemiology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart</topic><topic>Humans</topic><topic>Lipids - blood</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>National Health Programs</topic><topic>Proportional Hazards Models</topic><topic>Risk Factors</topic><topic>Smoking - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>WILSON, P. W. F</creatorcontrib><creatorcontrib>D'AGOSTINO, R. B</creatorcontrib><creatorcontrib>LEVY, D</creatorcontrib><creatorcontrib>BELANGER, A. M</creatorcontrib><creatorcontrib>SILBERSHATZ, H</creatorcontrib><creatorcontrib>KANNEL, W. 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B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prediction of coronary heart disease using risk factor categories</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>1998-05-12</date><risdate>1998</risdate><volume>97</volume><issue>18</issue><spage>1837</spage><epage>1847</epage><pages>1837-1847</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>The objective of this study was to examine the association of Joint National Committee (JNC-V) blood pressure and National Cholesterol Education Program (NCEP) cholesterol categories with coronary heart disease (CHD) risk, to incorporate them into coronary prediction algorithms, and to compare the discrimination properties of this approach with other noncategorical prediction functions.
This work was designed as a prospective, single-center study in the setting of a community-based cohort. The patients were 2489 men and 2856 women 30 to 74 years old at baseline with 12 years of follow-up. During the 12 years of follow-up, a total of 383 men and 227 women developed CHD, which was significantly associated with categories of blood pressure, total cholesterol, LDL cholesterol, and HDL cholesterol (all P<.001). Sex-specific prediction equations were formulated to predict CHD risk according to age, diabetes, smoking, JNC-V blood pressure categories, and NCEP total cholesterol and LDL cholesterol categories. The accuracy of this categorical approach was found to be comparable to CHD prediction when the continuous variables themselves were used. After adjustment for other factors, approximately 28% of CHD events in men and 29% in women were attributable to blood pressure levels that exceeded high normal (> or =130/85). The corresponding multivariable-adjusted attributable risk percent associated with elevated total cholesterol (> or =200 mg/dL) was 27% in men and 34% in women.
Recommended guidelines of blood pressure, total cholesterol, and LDL cholesterol effectively predict CHD risk in a middle-aged white population sample. A simple coronary disease prediction algorithm was developed using categorical variables, which allows physicians to predict multivariate CHD risk in patients without overt CHD.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>9603539</pmid><doi>10.1161/01.cir.97.18.1837</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0009-7322 |
| ispartof | Circulation (New York, N.Y.), 1998-05, Vol.97 (18), p.1837-1847 |
| issn | 0009-7322 1524-4539 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_79887099 |
| source | EZB Electronic Journals Library |
| subjects | Adult Aged Algorithms Biological and medical sciences Blood Pressure Body Mass Index Cardiology. Vascular system Cholesterol - blood Cholesterol, LDL - classification Cohort Studies Comorbidity Coronary Disease - epidemiology Coronary heart disease Diabetes Mellitus - epidemiology Female Follow-Up Studies Heart Humans Lipids - blood Male Medical sciences Middle Aged National Health Programs Proportional Hazards Models Risk Factors Smoking - epidemiology |
| title | Prediction of coronary heart disease using risk factor categories |
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